Earlymortality after implantable cardioverter defibrillator: Incidence and associated factors

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:301

Article

Garcia, Rodrigue¹  Defaye, Pascal³  Sadoul, Nicolas⁴  Narayanan, Kumar⁵  Perier, Marie-Cecile⁶  Klug, Didier⁷  Fauchier, Laurent⁸  Leclercq, Christophe⁹  Babuty, Dominique⁸  Bordachar, Pierre¹⁰  Gras, Daniel¹¹  Deharo, Jean-Claude¹²  Piot, Olivier¹³  Providencia, Rui²  Marijon, Eloi^14,16,17  Algalarrondo, Vincent^15,16,17 

[1] CHU Poitiers, F-86021 Poitiers, France

[2] Clin Pasteur, F-31076 Toulouse, France

[3] CHU Michallon, F-38700 Grenoble, France

[4] CHU Brabois, F-54500 Vandceuvre Les Nancy, France

[5] Maxcure Hosp, Hyderabad 500081, Telangana, India

[6] Insemi 11970, Paris Cardiovasc Res Ctr, F-75015 Paris, France

[7] CHRU Lille, F-59000 Lille, France

[8] CHU Trousseau, F-37170 Chambray Les Tours, France

[9] CHU Poutchaillou, F-35000 Rennes, France

[10] CHU Haut Leveque, F-33604 Pessac, France

[11] Hop Plive Confluent, F-44277 Nantes, France

[12] CHU Timone, F-13005 Marseille, France

[13] Ctr Cardiol Nord, F-93200 St Denis, France

[14] Harts Heart Ctr, Harts Hlth NHS Trust, London PGIA 7BE, England

[15] Paris & Univ Paris Descartes, AP HP, Hop Europeen Georges Pompidou, F-75006 Paris, France

[16] CHU Bichat Claude Bernard, AP HP, F-75018 Paris, France

[17] Univ Paris Diderot, F-75018 Paris, France

关键词: Implantable cardioverter defibrillator;    Guideline;    Mortality;    Sudden cardiac death;    Heart failure;    Prevention;   

DOI  :  10.1016/j.ijcard.2019.09.033

来源: Elsevier

【 摘 要 】

Background: According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a reasonable expectation of survival with a good functional status >1 year. Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a =1-year survival among patients implanted with ICDs. Methods: The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002-2012 period. Characteristics of patients who survived <= 1 year following the implantation were compared with those who survived N1 year, and predictors of early death determined. Results: Out of the 5539 enrolled patients, survival status at 1 yearwas known for a total of 5,457, and overall 230 (4.2%) survived <= 1 year. Causes of deathwere similar in the two groups. Patientswith <= 1-year survival had lower rates of appropriate (14 vs. 23%; P= 0.004) and inappropriate ICD therapies (2 vs. 7%; P = 0.009) than patients who lived N1 year after ICD implantation. In multivariate analysis, older age, higher NYHA class (>= III), and atrial fibrillation were significantly associatedwith <= 1-year survival. Presence of all 3 risk factors was associatedwith a cumulative 22.63% risk of death within 1 year after implantation. Conclusions: This is the largest study determining the factors predicting earlymortality after ICD implantation. Patients dying within the first year had low ICD therapy rates. A combination of clinical factors could potentially identify patients at risk for early mortality to help improve selection of ICD candidates. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

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